Friday, January 30, 2009

Nathan's Clubfoot

When I was pregnant with Nathan I was sent for a Level 2 U/S at 20 weeks. At that U/S the tech was very nice, but very business like. She never mentioned anything good or bad about what she was seeing. That is their job: they are not supposed to say the good stuff or else when they are quiet a nervous mother will assume the worst. I'd had 11 U/S prior to this one so I was calm and just considered it routine. She left the room and said that she was going to look at the images and be sure that she had everything she needed. She then came back and said, “This is not something I really do, but the doctor that is on staff today was called away for an emergency c-section.” Now I was a nervous. I had driven to this appointment on my own and was all alone. She then said to me, “The left foot appears to be clubbed.” I was crying at this point. All I knew of clubfoot are the images shown on Save the Children commercials and others like it. She was very calming and told me that a report would be sent to my OB, and that I needed to reschedule for another U/S in one month. I left that appointment in a crying daze. I was bawling on the way home and scared about what was in store for my poor little baby. I blamed myself for being so sick, for the medications I had to take, for everything that was going wrong with my pregnancy.

After calming down and finding horrible photos on the internet, I found a non-surgical procedure to correct his foot. It's called the Ponseti Method, named for Ignacio Ponseti who developed this amazing procedure. I began to research it more and look for a Ponseti certified doctor with a great reputation. I found that one of the best, Dr. Dobbs, worked right here at St. Louis Children's Hospital (as well as Shriner's). I set up an appointment with him before Nathan was born. I met him and his nurse Kristina and loved them both. I was teary for that appointment and they were so reassuring that he would never be in pain. I did not want him to have surgery. Surgery would mean that he would most likely have pain as he grew older, a foot that did not look 'normal', and more surgeries as he grew, not to mention the fear of the complications of any surgery.

When he was born we called to schedule an appointment. He was 8 weeks when he began treatment because he was small and Dr. Dobbs likes to wait until a baby is 7 pounds. He got his first cast and didn't cry during the procedure. He did not like the removal the following week, but the warm cast being applied was quite calming to him. He needed 5 casts (a new one each week. Each new cast his foot was moved a tiny bit more into the correct position. He had a tenotomy which is a very small poke of the heal tendon to loosen his ankle and he didn't cry, just sucked his bottle. Then his last cast (#5) was applied.

After he was done with his casts he was given a brace to wear for 23 hours a day. Eventually this wear time was decreased and he now only wears it when he is sleeping. He doesn't mind getting it on at all and actually does not like to sleep without if we are away and don't have it with us. The brace is a new version of the original brace used in the Ponseti Method. Dr. Dobbs created a brace that allows the baby to move their feet independently. Prior to his brace, the only brace used was a solid bar connected to 2 shoes. The child could move their feet together up and down and bent and straight, but not kick them one at a time. With the Dobbs brace, Nathan could move freely like other babies and keep his leg muscles strong and stretched while wearing it. It was very easy for him to move around and in no way restricted his development. He crawled and pulled up and cruised as early or earlier than the typical age for any baby.

His foot is as perfect as any and matches his right foot in size and shape. No one would ever know that he was born with a clubfoot and he will be able to run, jump, and play sports. He'll be wearing the brace when he's sleeping until he's 4 or 5 and my only concern is how he will sleep the first couple nights after he's not using it anymore.

my baby was born clubfoot (both feet). in malaysia, ponseti method is kinda new where only few doctors know how to apply it. right now i am having problem to maintain my baby feet's condition coz we are using traditional braces and my baby refused to wear it since he started to crawl. how much do u bought the dr dobbs braces? i doubt if i can find that braces in malaysia. :(

I'm so glad you wrote about this, with photos-- his little foot (first photo) is so pretty and precious-- sweet baby foot, baby skin. I'm sure you were so scared, not being able to picture it, and not realizing how not-scary it would actually look. And the last pictures--fat baby feet! So sweet. I think this will be really reassuring to other moms and people around pregnancies and new babies.

I've only just stumbled across your blog and am so glad I did. I was born with slight clubfoot and had to wear braces and casts on both my legs for the first six weeks of my life. I have no problems at all now with my feet.

It is so wonderful that your little Nathan's feet are better, such an amazing difference. Your documentation of the journey is beautiful as well.

You expect me to explain myself to you?

My fabulous husband, Greg, and I have been married since 2003. We have 2 boys. Carson is 4 years old and learning so fast. Nathan is 2 years old and that boy can not be slowed down. Our house is never quiet or clean, but it is full of life.
*WARNING: I write using a superfluous, unjustified number of parenthetical phrases.*